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Part II of "Me Time"  Read more here

 
 
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Are you coping with a chronic illness?  Read tips on prioritizing to find "Me Time" in Part I here!

 
 
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Photo Credit: http://thedynamicturnaround.com
For parents, it helps to have good communication and boundaries when raising a child who struggles with chronic illness.


Read my article here!

 
 
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Cheesman Park
If you're looking for a new approach to therapy, then Walk & Talk is for you!  My clients are raving about the energy and creativity that this form of counseling brings to them.  Why sit on a couch, when you can enjoy the beautiful parks of Denver?

For more information, call me at (720) 425-5334!

 
 
I am pleased and excited to share my new office with you!  Beginning Monday, May 20th we will meet at: 

1731 E. 16th Avenue, Denver 80218

It is on the corner of 16th Avenue and Williams in City Park West.  Also in the building are a psychiatric nurse practitioner, play therapist and esthetician.  See you there!

 
 
 
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Denver Walk & Talk Therapy – 
Moving You Forward!

What is it?
Walk & Talk therapy is a form of psychotherapy that incorporates walking while talking about issues and problem-solving. 

It is a workout?
Not necessarily.  Walking helps get the blood moving, thus encouraging more on-the-spot thinking and creativity.  We will walk at a pace where you feel comfortable.

What if I can't walk for 45 minutes?
No problem!  We will walk at a comfortable pace and distance.  There are benches throughout the parks if we need to sit for awhile.

What about the weather?
You decide if you’re willing to brave the elements.  If the weather is inclement, we can meet at my office.  However, some people find walking in the soft rain or gently falling snow invigorating.

What should I wear?
Dress comfortably and wear good walking shoes.  You might consider bringing a hat or sunglasses, as well as a bottle of water.

Where will we meet?
The initial session will take place in my office so we can complete intake paperwork. 

Subsequent visits will take place at either City Park (Mondays), Cheesman Park (Wednesdays), or Washington Park (Fridays).  Meet-up location and directions will be given before the appointment.  

Is this a good option for my child?
Walk & Talk therapy is an excellent option for adolescents who have trouble opening up to adults and expressing their feelings.  An ‘office without walls’ helps youth feel free to talk more openly.

What about confidentiality?
Many people walk through the park at any given time.  We will be talking about private issues and others may overhear bits and pieces of our conversation.  However, we will take appropriate measures to ensure that your confidentiality is maintained to the best of our ability.


 
 
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How many of you are ‘outdoor kids’?  I know I am!  After living in Florida and now Colorado, I've come to appreciate my time outside running, hiking, camping, biking and walking, either alone or with friends.  Sitting inside on a sunny day (or any day for that matter!) makes me feel antsy, like I should be outside doing something.  I've determined that feeling at least partially stems from my younger years in the Midwest, where nice days seemed few and far between. 

Know what else makes me (and lots of other people) feel restless?  Sitting in an office.  Close your eyes for a moment and imagine yourself at your workplace (OK, read through this first, and then close your eyes!).  Are you sitting in front of a computer?  Are you surrounded by four walls?  Can you hear the buzz of the florescent lighting?  You yawn and find it difficult to concentrate.  You go for a second (or third?) cup of coffee to make it through the afternoon, yet your creativity is lacking and you just can’t find a solution to the problem at hand.  Sound familiar?

Now, close your eyes once again and vision yourself as a child, running around outside barefoot on a summer day.  Picture you talking and laughing with a friend.  The sun is bright and warms your skin.  Birds are chirping in the trees and you feel a slight breeze.  Your blood is pumping and you feel energized.  The surroundings ignite your imagination, and you develop a plan to conquer the bad guy or change the world.  When you finally get called in for the night, you think about your successful adventure…and your body and mind rest peacefully.

The bottom line: Inactivity causes our heart rate to slow, reducing blood flow to our brain and to the rest of our body, blocking our vision and ingenuity.   It can also lead to health problems.  On the contrary, being active has physical and mental effects.  Positive effects.  Personally and professionally I have experienced this connection between the mind and body, and more studies are showing the link between mental and physical health (Good for you, science!).  Clearly, some medical challenges can be overcome with exercise, and we now know that depressive and anxious symptoms (among others) are greatly reduced with exercise too.     

So if movement improves our physical health and mental clarity, shouldn't we combine them?

Absolutely!  It’s called: Walk & Talk Therapy.

This style of therapy has been around for several years, and it is a big contrast to sitting on a couch talking about problems.  Sitting stagnant in an office can sometimes result in dull problem-solving skills, but walking outside gets the blood flowing to your brain, thus improving positive thoughts, creativity and problem-solving skills.

We’ll talk details of Walk & Talk Therapy in Part 2…



 
 
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Nancy A. Melville Nov 16, 2012

SAN DIEGO, California – The benefits of exercise in nearly every aspect of physical health are well known, but evidence in recent years suggests a unique effect on some psychiatric disorders, prompting mental health clinicians to rethink treatment strategies and to consider the possibility of exercise not just in therapy but as therapy.

"Above and beyond the standard benefits of exercise in healthy living and general well-being, there is strong evidence demonstrating the ability of exercise to in fact treat mental illness and have significant benefits on a neurotrophic, neurobiologic basis," Douglas Noordsy, MD, told delegates attending Psych Congress 2012: US Psychiatric and Mental Health Congress.

Some of the strongest evidence is seen in depression, where psychiatric benefits from exercise have been shown in some cases to match those achieved with pharmacologic interventions and to persist to prevent remission in the long term.

Dr. Noordsy referenced a study from researchers at Duke University in which 156 patients with major depressive disorder (MDD) were randomly assigned either to aerobic exercise, sertraline therapy (50 mg to 200 mg), or both for 4 months.

The difference in remission rates in the exercise and selective serotonin reuptake inhibitor (SSRI) groups after 4 months were not significant – 60% and 69%, respectively, but at a 10-month follow-up, the exercise group showed a significantly lower relapse rate ( P = .01) ( Psychosom Med 2000;62:633-638).

"The patients who were independently exercising on their own after the treatment period had half the odds for meeting the depression criteria 6 months later compared to patients who didn't exercise after the 4-month study," said Dr. Noordsy, an associate professor and director of psychosis services at the Geisel School of Medicine at Dartmouth College, in Hanover, New Hampshire.

A similar study from the same group of researchers 10 years later in a larger sample involving 202 patients assigned to supervised exercise, sertraline therapy (50 mg to 200 mg) or placebo showed remission rates of 46% at 4 months and 66% at the 16-month follow-up across both treatment groups, with no significant greater improvement with SSRIs compared with exercise in predicting MDD remission at 1 year ( Psychosom Med 2011 Feb-Mar;73:127-33; epub 2010 Dec 10).

Other studies have shown equally impressive results in exercise for a variety of populations, including pregnant women with depression, who have a high interest in avoiding medications, people with HIV, and even patients with heart failure, who showed not only a significant reduction in depression related to exercise but also reduced mortality ( Am J Cardiol 2011;107:64-68).

Anxiety
The evidence in relation to anxiety, although not as strong, still suggests a benefit, and the rigors of a cardiovascular workout seem particularly suited to addressing the physiologic effects associated with anxiety, Dr. Noordsy said.

"We know that with anxiety, the heart rate goes up, you start breathing fast, and it kind of snowballs with more anxiety, and that can trigger a panic attack," he explained.

"So one of the important positive effects of physical exercise is it allows people to become conditioned to having their heart rate and respiratory rate increase when they're not associated with anxiety, thereby addressing the triggers."

Evidence is somewhat lacking in the area of bipolar disorder, but patients often have symptoms similar enough to depression to suggest a benefit, Dr. Noordsy said.

"The evidence on depression in bipolar disorder is strong enough that I certainly feel comfortable in talking about exercise as part of [bipolar patients'] management."

In terms of more serious psychotic disorders such as schizophrenia, evidence is limited on benefits of exercise for the core symptoms of psychosis or cognition. However, several studies have shown improvement in comorbidities and metabolic issues related to antipsychotics that such patients commonly face.

One study of a jogging intervention among 80 inpatients with chronic schizophrenia, in which 40 patients jogged for 40 minutes 3 times a week, depression, anxiety, phobia, and obsessive-compulsive behaviors declined significantly compared with 40 inpatient control participants who were inactive and showed no improvement.

Dementia Prevention
The evidence on the benefits of exercise in cognitive function disorders, such as dementia and Alzheimer's disease, is much more extensive, with as many as 8 strong studies on dementia alone in the last 3 years showing improvements with activities such as walking and strength training on memory and executive function.

Dr. Noordsy noted one particularly remarkable study in which researchers compared patients with and without the ApoE gene, which is linked strongly to late-onset Alzheimer's disease.

In the study, patients who were ApoE-negative showed similarly low mean cortical binding potential, related to plaque buildup in the brain, regardless of whether they exercised or not.

But although ApoE-positive individuals (n = 39) had values that were substantially higher, the ApoE-positive patients who exercised (n = 13) had values similar to those who did not carry the gene ( Arch Neurol 2012;69:636-643).

"You could look at these results and rightfully say physical exercise neutralizes your risk for developing Alzheimer's disease if you're ApoE positive," Dr. Noordsy said.

The bottom line: "Instead of 'this is something you ought to be doing,' we might instead say, 'this is something humans are designed to do, and when we don't do it, our bodies and brains fall apart'."

Read the rest of the article on Medscape.com here.  

Psych Congress 2012: US Psychiatric and Mental Health Congress. Presented November 9, 2012.

 
 
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http://visual.ly/how-carve-your-thanksgiving-calories
It's that time of year again!  Time for family and friends.  Time for holiday spirit.  And time for parties.  Those three things combined can also mean too much of a good thing!

It's our culture's tradition to be festive and indulgent this time of year.  But how can we enjoy the holidays without over-stuffing ourselves on food, drink and fun?

Here are a few tips:
1. Be social  Focus on the festivities, rather than food or drinks.  Spend your time chatting with people instead of standing in the kitchen or around the bar.

2. Be green  Be the one who brings green to the table.  Salads, veggies and fruits are healthy and filling options.

3. Be active  Don't take a holiday from your healthy lifestyle.  Run, walk, ski, hike or go to the gym.  On non-party days, follow your usual nutrition plan, and scale back on calories after a gathering.

We can enjoy the holidays and still maintain a healthy lifestyle.  So Healthy Holidays to you and yours!


 
 
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November 14, 2012 is World Diabetes Day.  Diabetes is a chronic disease that arises when the pancreas does not produce enough insulin, or when the body cannot effectively use the insulin it produces. Insulin is a hormone made by the pancreas that enables cells to take in glucose from the blood and use it for energy.  Failure of insulin production, insulin action or both leads to raised glucose levels in the blood (hyperglycemia).  This is associated with long-term damage to the body and the failure of various organs and tissues.  

Diabetes is difficult. It imposes life-long demands on people with diabetes, requiring them to make multiple decisions related to managing their diabetes.  People with diabetes need to monitor their blood glucose, take medication, exercise regularly and adjust their eating habits.  Furthermore, they may have to face issues related to living with the complications of diabetes and may be required to make considerable psychological adjustments.* 

Five Tips for Coping with Diabetes:

1. Comply with practitioners’ recommendations
Not many people want to be reliant on medication or supplements.  However, missing a dose of prescribed meds/treatments can lead to withdrawal, headaches, anxiety, depression and other physical and emotional symptoms.  Make it a daily goal to take medicine and use other treatments as prescribed. 

2. Find support
A trustworthy support network of family and friends will give you moral support.  A counselor can help you work through your issues and set goals without judgment.  Support groups designed for people with the same diagnosis can help you realize that you are not alone in your journey.

3. Exercise
Daily exercise increases blood flow to your brain and increases the “feel good” chemicals (endorphins).  Physical movement along with outdoor activities leaves us feeling happy and satisfied.  Talk with your doctor about the right kinds of exercises for you.

4. Understand what you can control
Making a list of “Things I can’t control” and “Things I CAN control” helps put our power into perspective.  There are very few things we can’t control…and countless things we can!  Be sure to include traditional and alternative medicine, emotions, behaviors and relationships in your lists. 

5. Be positive
Being optimistic and confident both inwardly and outwardly lead to increased positivity…which improves mental and physical health.  Create a motto or mantra with positive key words that you can repeat daily to yourself.

Being diagnosed with a chronic medical condition like diabetes doesn’t have to be the end of the world…it can be the beginning of discovering your true strengths and abilities!

* Taken from the International Diabetes Foundation: http://www.idf.org/